Cervix Research Articles

Methylation, Gene Expression, and Risk Genotypes at the TERT-CLPTM1L Locus in Cervical Cancer.

The reverse transcriptase subunit of telomerase, TERT, is frequently activated in high-grade dysplasia and invasive cancers of the uterine cervix. Telomerase activation through hypomethylation of the TERT promoter holds promise as a biomarker for cervical cancer progression, however, specific CpG sites involved in cervical cancer risk remain to be fully defined. A recent genome-wide association study on cervical cancer identified genetic polymorphisms at 5p13.33 (close to TERT-CLPTM1L) but the underlying mechanisms are undetermined. We investigated 529 CpG sites within the TERT promoter region and 3 CpG islands nearby, and 21 CpG sites within CLPTM1L in 190 bisulfite-converted cervical tumor DNA samples from BioRAIDs (NCT02428842). We identified eight CpG sites within TERT intron 2 where methylation was significantly associated with the genotypes of cervical cancer risk variants rs27070 and rs459961 in cervical tumors after multiple testing correction (p < 9.4 × 10E-5). Hypermethylation at chr5:1289663 correlated with decreased TERT mRNA levels. In an independent series of 188 normal or dysplastic cervical tissues, rare alleles of rs27070 and rs459961 were associated with low basal CLPTM1L levels and with the absence of TERT mRNA in HPV-negative samples, consistent with their proposed role as protective variants for cervical cancer. HPV infection was associated with increased CLPTM1L and TERT levels. Collectively, our results provide a link between cervical cancer risk variants, methylation, and gene expression and implicate both TERT and CLPTM1L as genes modulated by genomic background and HPV infection during cervical cancer development.

P2X4 receptor mediates macrophage infiltration leading to endometriotic cyst epithelium proliferation and hyperalgesia in mouse model

To evaluate the effects of a P2X4 receptor (P2X4R)-specific antagonist on murine endometriotic-like lesions and human endometriotic stromal cells. Experimental study using an in vivo mouse endometriosis model and in vitro primary culture of human endometriotic stromal cells. NC-2600, an antagonist of the P2X4 ionotropic ATP receptor (P2X4R), was orally administered to the mice and cells. Gene expression analyses for cytokines were conducted in the endometriotic-like cysts and vaginal portion of mice, and immunohistochemistry was performed to evaluate the proliferative activity and localization of macrophages in addition to cytokine expression. The sensation of murine vaginal pain was evaluated using visceromotor responses. The study was performed in academic and hospital research laboratories. NC-2600 reduced the proliferation of the cyst epithelium and vaginal pain sensation. In both cysts and vaginas, P2X4R is mainly expressed in macrophages, and NC-2600 reduces the number of tissue macrophages and reverses the elevated expression of InterleukinL-33 and cyclooxygenase-2 in animals with endometriosis. These results indicate unknown pathophysiological roles of P2X4R expressed in local macrophages at the injury site of endometriosis and in the vagina, suggesting the potential therapeutic effects of orally administered P2X4R inhibitors for alleviating the symptoms of endometriosis.

Cisplatin-Containing Combinations Associate with Survival in Women from Appalachian Kentucky with Metastatic, Persistent, or Recurrent Uterine Cervix Cancer.

Background: Prior preclinical studies showed promising antitumor activity and an acceptable safety profile associated with radiopharmaceuticals for patients with metastatic, persistent, or recurrent uterine cervix cancers. Whether the addition of a radiopharmaceutical to chemotherapy would significantly increase progression-free survival in such patients is untested. Our retrospective study sought to associate the line of treatment and progression-free survival as benchmarks for next-generation radiopharmaceutical development. Methods: We grouped metastatic, persistent, or recurrent uterine cervix cancer patients not amenable to curable surgery or radiotherapy between 2002 and 2023 by the line of doublet, triplet, and quadruplet chemotherapy or another intervention. After the first-line treatment, patients were monitored for radiographic progression every three months for up to three years. The primary endpoints were the first and any second or third progression-free survival intervals. Results: A total of 127 patients contributed demographic, tumor, line of treatment, and outcome data with a median follow-up of 18 months (25-75% interquartile range: 9 to 37 months). After the first-line treatment, 113 patients had local or distant progression or died from any cause, most often death from the disease (67%). Median progression-free survivals were 5.5 months (95% confidence interval: 4.8-6.0 months), 5.3 months (95% confidence interval: 4.5-6.3 months), and 3.0 months (95% confidence interval: 2.1-3.7 months) for the first-, second-, and third-line treatments, respectively. For a first-line cisplatin-containing regimen, the median progression-free survival was 6.5 months (95% confidence interval: 5.5-7.7 months). Conclusions: This study highlights the limited efficacy of current treatments for metastatic, persistent, or recurrent uterine cancer patients. A five-month progression-free survival might serve as a benchmark for the development of novel therapies in clinical efficacy trials, such as radiopharmaceuticals.

Adenoid basal carcinoma cervix – A rare epithelial neoplasm

ABSTRACT Adenoid basal carcinoma of the uterine cervix is a rare epithelial neoplasm. Adenoid basal carcinoma constitutes less than 1% of all cervical adenocarcinomas and has a favorable prognosis. Adenoid basal carcinoma is assumed to arise from a multipotential basal or reserve cell layer in the cervical epithelium. We report a case of adenoid basal carcinoma of the uterine cervix with complaints of bleeding per vagina in a 40-year-old female. The carbohydrate antigen 125 level was elevated (100 U/ml), and the MRI abdomen and pelvis revealed increased signal intensity in the anterior lip of the cervix. The local examination revealed thickening of the anterior lip of the cervix and induration in the left fornix. The patient was diagnosed with carcinoma cervix stage IB2 (FIGO Stage). The patient was operated by a radical robotic hysterectomy. Microscopic examination revealed small basaloid tumor cell nests with peripheral cell palisading and microcyst formation. The tumor cells showed p63 immunoreactivity in basaloid tumor cells and were negative for CD117 and S-100P. This tumor should be differentiated from adenoid basal cell hyperplasia, which has a favorable outcome, and adenoid cystic carcinoma, with a dismal course.

Treatment with Epigallocatechin Gallate, Folic Acid, Vitamin B12, and Hyaluronic Acid Decreases HPV Positivity in Women Attending Regional Screening in Puglia.

Human Papillomavirus (HPV) infection represents a global health concern. HPV infects the mucosa, particularly in the uterine cervix, where it may establish a persistent infection, exposing women to a risk of developing cancer. The available treatments include surgery or topic solutions, while a systemic treatment is still unavailable. In recent years, natural molecules such as epigallocatechin gallate (EGCG), folic acid (FA), vitamin B12, and hyaluronic acid (HA) gained importance as innovative therapies for HPV. We enrolled 163 women with a positive HPV DNA test or previous history of HPV infections, and a PAP test indicating LSIL/AGUS/ASCUS cytology. The patients in the treatment group (n = 86) received an oral combination of EGCG 200 mg, FA 400 µg, vitamin B12 1 mg, and HA 50 mg (1 cps/day) for 3 months (T1), while the control group (n = 77) underwent standard clinical surveillance. Both groups repeated a PAP test and an HPV DNA test after 3 (T1) months, and another PAP test after 6 months (T2) as a follow up. The treatment group experienced a significant reduction in HPV positivity at T1 compared to the control group. Moreover, the treatment group exhibited an improvement in cervical lesions either at T1 (p < 0.0001) or T2 (p < 0.00001).

Nanoindentation-induced serrated flow behavior and deformation mechanism in metallic glass: A combined experiments and molecular dynamics simulation

In this study, the deformation behaviors of bulk metallic glass (BMG) during the nanoindentation are presented via the experiments and molecular dynamics (MD). The relationship between shear transformation zone (STZ) formation and serrated flow dynamics are developed to explain the deformation characterization evolution of BMG. It is found that as the peak load increases, the hardness and elastic modulus significantly decrease. Creep behavior at room temperature was also revealed by analyzing the creep displacement curve and the stress index under different peak loads.The accumulation of free volume during the deformation process promotes more uniform creep deformation. Furthermore, the serrated flow behaviors were analyzed innovatively using the shear stress drops further statistically. At lower loads, the occurrence of serrated retention is due to energy exceeding the potential barrier required for flow unit activation, ultimately released in the form of kinetic energy. At higher loads, the transition from intermittent curve to smooth curve exhibits a typical self-organized critical (SOC) state dynamic characteristics, and ISE phenomenon is also observed. The results also suggested that the shear deformation of the spherical indenter is more pronounced, with the shear band forming at a 45° angle to the direction of the downward pressure. And based on the Cooperative shear model (CSM) theory, the STZ size was estimated and verify that the increment of STZ makes it easier to generate stronger plastic strain to dissipate STZ, ultimately leading to complete plastic deformation. Combining five fold symmetry and gradient atoms, the majority of atoms with five fold symmetry (LFFS>0.5) have stronger resistance to plastic deformation when the load rate is low.

A Study on the Effects of Depth-Dependent Power Loss on Speckle Statistics Estimation

Characterization of the interference patterns observed in B-mode images (i.e., speckle statistics) is a valuable tool in tissue characterization. However, changes in echo amplitudes unrelated to speckle, including power loss due to attenuation and diffraction, can bias these metrics, undermining their utility. Tissue with high attenuation such as the uterine cervix are especially affected. The purpose of this study was to demonstrate and quantify the effects of attenuation and diffraction on speckle statistics and to propose methods of compensation. Analysis was performed on simulated diffuse scattering phantoms of varying attenuation with simulated transducers at 9 and 5 MHz center frequency. Application in the in vivo macaque cervix using a clinical scanner is also presented. Nakagami and homodyned K distribution parameters were calculated in parameter estimation regions (PERs) of varying size within simulations and experiments. Changes in speckle statistics parameters with respect to PER size and depth were compared with and without two different compensation schemes. It has been shown that compensation for attenuation and diffraction is necessary to produce speckle statistics estimates that do not depend on medium attenuation or PER size. Reducing the dependence on these factors connects speckle statistics estimates more closely with the microstructure of the probed medium.

Deformation behavior of thermally rejuvenated Zr-Cu-Al-(Ti) bulk metallic glass

The deformation behavior of metallic glasses has been shown in prior studies to be often dependent on its structural state, namely higher energy “rejuvenated” state versus lower energy “relaxed” state. Here, the deformation behavior of thermally rejuvenated Zr-Cu-Al-(Ti) bulk metallic glasses (BMGs) was evaluated. Rejuvenation was achieved by cryogenic thermal cycling with increase of free volume measured in terms of enthalpy of relaxation. Hardness, stiffness, and yield strength of the BMGs were all found to decrease while plasticity increased after rejuvenation. More free volume in the rejuvenated BMG resulted in homogeneous plastic deformation as was evident from the high strain rate sensitivity and more pronounced shear band multiplication during uniaxial compression. Shear transformation zone (STZ) volume was calculated by cooperative shear model and correlated well with the change in structural state after rejuvenation. The enhanced plasticity with the addition of 1 at. % Ti as well as after cryogenic thermal cycling was explained by lower activation energy for shear flow initiation due to increased heterogeneity induced in the system. Molecular dynamics simulation demonstrated that the variation in plastic deformation behavior is correlated with local atomic structure changes.

Traditional female cervical cauterization and risk of preterm birth in Somalia: a single-center prospective observational study

Numerous traditional practices are both beneficial and harmful. Traditional harmful practices, such as female genital mutilation and traditional cervical cauterization, are carried out for a number of reasons but can have negative health and social effects. In addition to deeply held beliefs, a lack of knowledge and awareness of the consequences of these practices contributes to the persistence of these issues. The objective of this study is to examine whether traditional cervical cauterizations were associated with preterm births in Somalia. This prospective cohort study was conducted at our hospital over a one-year period. Seven hundred and two patients were included in this study; these patients were divided into two groups, cauterized and non-cauterized groups, and the two groups were compared on pregnancy outcomes. We examined whether traditional cervical cauterizations were associated with adverse pregnancy outcomes, including preterm births. According to the findings of this study, traditional cervical cauterization was prevalent among patients visiting MSTREH (n = 328, 46.7%). Infections of the uterine cervix and infertility were the two main indications for cauterization, 44.8%, and 34.8%, respectively.Being older, uneducated, and poverty were significantly associated with traditional cauterization (P < 0.001). There was a significant correlation between prior traditional cervical cauterization and the risk of preterm births. Women with prior cauterization were two and half times more likely to deliver a preterm fetus (OR: 2.64, 95% CI 2.15–3.33) compared to non-cauterized mothers. Our findings show that women who have previously undergone traditional cervical cauterization have a significantly higher risk of preterm birth and negative pregnancy outcomes than non-cauterized women. Health professionals, particularly those who are close to the community, are crucial in developing and putting into practice plans to end harmful traditions in Somalia.

Mechanical performance of amorphous diamond-like carbon nanowires

Amorphous carbon nanowires (NW) are a fundamental piece in the study of novel nanoarchitectures with unexpected mechanical properties. However, the failure mechanism of amorphous carbon NW is still missing. In this study, classical molecular dynamics was employed to conduct stress-strain tests to address the mechanical response of amorphous carbons NW with different radii. This research characterizes the mechanical properties of aC NW with different sp3 contents, including Youngs modulus and ultimate tensile stress. Our study reveals that plastic deformation is mediated by chemical modifications in carbon bonding, leading to transitions from sp2 to sp3 and vice versa. We observed that denser amorphous carbon materials undergo a transition from sp3 to sp2 bonding prior to failure, facilitated by the recombination of sp2 clusters. Additionally, plastic deformation in amorphous carbon NW is facilitated by the formation of shear transformation zones and nanovoids, with the deformation mechanism strongly dependent on the average coordination of carbon atoms. These insights provide valuable information for designing nanomaterials with tailored mechanical properties.

Long-term outcomes of sentinel lymph node navigation surgery for early-stage cervical cancer

BackgroundSentinel lymph node navigation surgery, which identifies the sentinel lymph node in early cervical cancers and omits systemic pelvic lymphadenectomy in cases where no lymph node metastasis is present, has recently gained attention. However, there are few reports on lymph node recurrence and the long-term outcomes of cervical cancer surgery performed using sentinel lymph node navigation surgery. In this study, we aimed to evaluate the long-term outcomes of sentinel node navigation surgery for early-stage cervical cancer.MethodsOne hundred thirty-eight patients with cervical cancer were enrolled. Sentinel lymph nodes were identified by injecting 99 m Technetium-labeled phytate and indocyanine green into the uterine cervix. Surgery and survival outcomes were also analyzed.ResultsThe median age and body mass index of the patients were 40 years (20–78) and 21.7 kg/m2 (16.5–50.4), respectively. Open surgery, laparoscopic surgery, and robotic surgery were performed in 77 (56%), 53 (38%), and 8 (6%) patients, respectively. The overall and bilateral detection rates of the sentinel lymph node were 100% and 94%, respectively. Only one case (0.7%) exhibited lower extremity lymphedema, and pelvic lymphocele was observed in three cases (2.2%). Four cases (3%) experienced recurrence over a median follow-up of 57.5 months (range, 2–115 months), with five-year recurrence-free and overall survival rates of 97% and 97.3%, respectively.ConclusionsOur results demonstrate that sentinel node navigation surgery may be safe and effective for early-stage cervical cancer.

Prevalence of unexpected malignant disease in the histopathology of hysterectomy indicated for benign condition

To describe the prevalence of incidental malignant pathology following a hysterectomy performed for benign reasons. A descriptive cross-sectional study based on hospital records. Women who underwent hysterectomy for benign reasons at a general referral hospital between 2013 and 2021 were included. Women with obstetric hysterectomy were excluded. Measured variables: age, route of hysterectomy, type of hysterectomy, histopathological diagnosis of premalignant lesion or invasive cancer, type of cancer. Analysis: Descriptive, the prevalence of preneoplastic and neoplastic conditions was estimated for the overall period. Of 816 clinical records, 674 cases (87 %) met the inclusion criteria and were analyzed. The premenopausal population predominated. Twentysix cases of unexpected malignant disease were identified, yielding a prevalence of 3.8 %, and 13 cases of premalignant pathology (1.9 %). The most common origin was the cervix (40 %), followed by the ovary (33 %). Patients undergoing hysterectomy for benign conditions should be informed about the risk of unexpected injury. The importance of performing, in our context an adequate preoperative approach to rule out cervix uteri and ovarian cancer is emphasized. Follow-up studies of patients with unanticipated cancer are required to determine their treatment and prognosis in the region.

Comparative Study on Symptomatic Response and Toxicity of Concurrent Chemo-Radiotherapy and Radiotherapy Alone in the Treatment of Cervical Cancer

This prospective observational study was carried out to compare the symptomatic response and acceptable toxicity in concurrent chemo-radiotherapy and radiotherapy alone in the treatment of cervical cancer. A total of 60 patients (30 patients in arm A &amp; 30 patients in arm B) who have biopsy proven cervical carcinoma with no history of previous treatment were selected from the Department of radiotherapy Rajshahi Medical College Hospital, Rajshahi &amp; in the department of Radiation &amp; Oncology, National Institute of Cancer Research &amp; Hospital. All patients in both arms received external beam radiation with 50Gy in 25 daily fractions over five weeks. Followed by three insertions (one insertion per week) of Intracavitary brachytherapy each 700 cGy. Patients in arm-A received Inj. Cisplatin 40mg/m2 in IV infusion on the first day of each treatment per week in addition to radiotherapy. In this study it was observed that a significant symptomatic improvement was found in arm-A after treatment than arm-B and no severe unwanted reaction was noted in most of the patients. Systematic toxicity developed in both groups and comparatively more in arm-A (chemo radiation) but that was not statistically significant and well managed with conservative treatment. Regarding performance status patients treated with concurrent chemo radiation showed better performance status than the patient treated with radiotherapy alone. In this study it was observed that patients of carcinoma cervix treated with concurrent chemo radiotherapy was effective for symptomatic improvement and feasible with acceptable toxicity for advanced cancer of the uterine cervix than those with radiation alone.

The Effect of Seminal Plasma on the Equine Endometrial Transcriptome.

The establishment of pregnancy involves a fine-tuned balance between protection and tolerance within the maternal immune system, as the female needs to accept a foreign antigen (the semi-allogenic fetus) while still being able to combat pathogens from the uterus. In the horse, the first uterine exposure to paternal antigens is during mating when sperm is introduced to the tissue and draining lymphatics of the uterus. Additionally, it has been suggested that seminal plasma and its proteins within it play an essential role in preparing the female tract for a suitable immunologic environment but this has not been confirmed in the horse. Therefore, the objective of this study was to evaluate the endometrial transcriptome following insemination either with seminal plasma or with reduced seminal plasma. We hypothesised that reduced seminal plasma would alter the endometrial transcriptome and affect transcripts relating to immunotolerance, antigen presentation and embryo growth and development. To do so, six (n = 6) mares were inseminated in a randomised switch-back design over the course of four oestrous cycles. Mares were rectally palpated and scanned via ultrasonography for the detection of a pre-ovulatory follicle (>35 mm) alongside increasing uterine oedema and relaxed cervix, and then treated with one of four treatment groups including (1) 30 mL lactated Ringers solution (LRS; NegCon), (2) 500 × 106 spermatozoa in conjunction with 30 mL seminal plasma (SP+), (3) 30 mL lactated Ringers solution (LRS; wash out) and (4) 500 × 106 spermatozoa with seminal plasma reduced via gradient centrifugation and resuspended in 30 mL LRS (SP-). Human chorionic gonadotropin (hCG) was administered to standardise the time to ovulation and endometrial biopsies were collected 7 days after insemination. RNA was isolated utilising Trizol, and RNA-Seq was performed by Novogene, with 97.79% total mapping and 40 million read depth. p value was set to <0.05. When comparing SP+ to SP-, 158 differentially expressed genes (DEGs) were identified. Biological processes impacted included antigen processing and regulation, cholesterol synthesis, and immune/inflammatory response. Gene ontology (GO) enrichment analysis using DAVID v6.8 revealed that many of these DEGs were involved in biological process such as antigen presentation (HLA-DM beta chain, HLA-DRB, HLA-DQA and RASGRP1), immune cell signalling (CXCL9, CXCL1, DEFB1 and MIP-2B), embryo growth and development (INHA, KLF2, RDH10, LAMA3 and SLC34A2) and embryo metabolism (ABCA1, ABCA2, APOA1, LDL, INSR, IGFBP2 and IGFBP3). Overall, reduction of seminal plasma from the insemination dose impacted the endometrial transcriptome at the time of early embryonic exposure to the uterine environment. Further work is justified to evaluate these alterations impact on embryo maturation, placental development, pregnancy outcome and development of offspring.

Use of propranolol in [18F] FDG-PET/CT for differential diagnosis of brown fat in patient with a history of adenocarcinoma of the uterine cervix

Use of propranolol in [18F] FDG-PET/CT for differential diagnosis of brown fat in patient with a history of adenocarcinoma of the uterine cervix

Time trends in the clinical management of cervical intraepithelial neoplasia grade 2: A Danish register-based study.

Active surveillance for cervical intraepithelial neoplasia grade 2 (CIN2) has been implemented recently in many countries, including the Nordic countries. In Denmark, the only eligibility criterion for active surveillance for CIN2 is that the woman should be of reproductive age. With this study, we aimed to evaluate clinical and socioeconomic characteristics in women with CIN2 managed by active surveillance or large loop excision of the transformation zone (LLETZ) and to evaluate temporal changes in the clinical management of CIN2. We conducted a Danish nationwide study using data from healthcare registries. All female residents aged 18-40 years, diagnosed with incident CIN2 from January 1, 1998, to February 29, 2020, were included. We collected data on age, index cytology result, year of CIN2 diagnosis, region of residence, civil status, HPV vaccination status, and socioeconomic position indicators. The variables were tabulated overall and by management group (active surveillance vs. LLETZ). To evaluate time trends, we used joinpoint regression to calculate the annual percentage change (APC), including 95% confidence intervals (CI). Of the 27 536 women with CIN2 included, 12 500 (45.4%) underwent active surveillance, and 15 036 (54.6%) underwent a LLETZ. Women undergoing active surveillance were younger, more often HPV-vaccinated, and more likely to have a normal/low-grade index cytology result than women undergoing LLETZ. Socioeconomic position indicators did not differ. Over time, the proportion of women undergoing active surveillance increased from 21.7% in 2004 to 73.6% in 2019 (APC 9.7, 95% CI 8.1-11.4). The proportion of women undergoing active surveillance aged <30 declined over time (APC -2.2, 95% CI -2.9 to -1.5). The proportion of women with normal/low-grade index cytology increased slightly to 51.6% in 2019 (APC 0.8, 95% CI 0.4-1.3). The use of active surveillance for CIN2 has increased over the past two decades in Denmark. Observed differences in characteristics between women undergoing active surveillance vs LLETZ are likely related to indications for clinical management.

Clinical characteristics and treatment outcomes of angioleiomyoma of the female genital tract: a retrospective cohort study

BackgroundAngioleiomyoma, a benign tumour composed of smooth muscle cells and thick-walled vessels, is expected to be very rare in the female genital tract. This study aimed to describe the clinicopathological features and treatment outcomes of angioleiomyoma in the female genital tract.MethodsWe retrospectively reviewed 89 women with angioleiomyoma in the genital tract who were treated at Third Xiangya Hospital of Central South University between July 2008 and October 2023. Symptom remission rate was the primary outcome of the study.ResultsAngioleiomyomas accounted for 0.6% of leiomyomas of the female genital tract. The average age of the 89 women was 41.8 ± 8.7 years. Seventy women (78.7%) had a history of uterine surgery, of whom two patients had removed uterine angioleiomyoma by laparoscopic myomectomy. The angioleiomyomas of 61 (68.5%) women were located in the uterine corpus, 17 (19.1%) in the broad ligament, 10 (11.2%) in the cervix and only 1 (1.1%) in the vagina. Abnormal uterine bleeding was the main clinical manifestation of angioleiomyomas located in the uterine corpus or cervix, whereas the main clinical manifestation of angioleiomyomas in the broad ligaments was pelvic mass. Of the 89 women, 59 underwent surgery to preserve the uterus, and 30 underwent total hysterectomy or subtotal hysterectomy. The intraoperative blood loss was more than 500 ml (700–4,500 ml) in six women. The symptom remission rate was 100% after surgery. Among the 59 women with preserved uterus, 8 showed multiple uterine leiomyomas during follow-up, but it was difficult to determine whether they were angioleiomyomas. Angioleiomyomas recurred in one women who underwent total hysterectomy.ConclusionAngioleiomyoma is rare in the female reproductive tract, and patients may present with diverse symptoms, which are related to the location of the tumour. Hysterectomy and myomectomy are both effective treatment methods, but the risk of intraoperative bleeding should be recognised for multiple lesions and those with large diameters. Relapse may occur in some patients.

Co60 May be the Acceptable Alternative Radionuclides of Ir192 used in HDR Brachytherapy for the Treatment of Inoperable Carcinoma Cervix in the Treatment Modality of Concurrent Chemoradiation

Background: Cancer of the uterine cervix is the eighth most common cancer among women worldwide and third among all malignancies and the second most common cancers in female in Bangladesh. The treatment of cervical cancer requires multidisciplinary approaches Concurrent chemoradiation is the treatment of choice in locally advanced carcinoma cervix uteri. Radiotherapy is the primary local treatment for most patients having FIGO stage IIB to IVA diseases. The success of treatment depends on a careful balance between EBRT and Brachytherapy that optimizes the dose to tumor. Iridium192 is highly used radionuclide for modern remote after loading HDR brachytherapy till date. Recently Co60 source is available with miniature size and identical physical properties for remote after loaders. Methods: 60 patients with biopsy proven locally advanced carcinoma of the uterine cervix were enrolled in the study. Arm A was formed comprising 30 patients who were treated by Ir192 HDR brachytherapy and Arm B formed with equal number of 30 patients who received HDR brachytherapy treated with Co60 radionuclide. This prospective observational study was carried out to compare the treatment effect between two Arm. Results: 60 patients were enrolled in this study with age range from 35 to 63 years. Most of the patients presented with stage IIB disease, consisting of 39 patients (65.3%). Among them 48 patients had squamous cell carcinoma (80.60%), adenocarcinoma trailing with 9 patients (15.3%) and rest were adenoidsquamous carcinoma 2 and small cell carcinoma. In all three insertions, urinary bladder dose distribution was slightly smaller by HDR Co60 irradiation than HDR Ir192 exposure. These differences were statistically significant in first two insertions but not in third one Conclusion: In this study radiation dose distribution at OARs i.e. urinary bladder and rectum were compared between Arm A and Arm B. In all three insertions in urinary bladder the mean dose distribution was slightly smaller in HDR Co60 irradiation than HDR Iridium192 exposure. These differences were statistically significant in first two insertions but not in third one. In case of rectum point, the mean dose distribution was significantly lower in all three insertions of Co60 exposure than Ir192 exposure.

Evaluation of estrus detection by cervical monitoring and pregnancy rates in ovsynch and co-synch treated Anatolian buffalo heifers

The aim of this study was to assess the relationship between the occurrence and intensity of estrous expression and the success of artificial insemination in Ovsynch and Co-synch treated Anatolian buffalo heifers, employing a novel approach utilizing smartphone-based endoscopic inspection of the cervix uteri. Twenty-seven Anatolian buffalo heifers (n=27) were utilized for the study. In the Ovsynch synchronization protocol (n=15), GnRH (buserelin acetate, 12 μg) was administered on day 0, PGF2α (cloprostenol, 500 μg) on day 7, and GnRH (buserelin acetate, 12 μg) on day 9, with artificial insemination conducted 16-20 hours after the second GnRH application. For the Co-synch protocol (n=12), GnRH (buserelin acetate, 12 μg) was administered on day 0, PGF2α (cloprostenol, 500 μg) on day 7, and GnRH (buserelin acetate, 12 μg) along with artificial insemination on day 10. At the time of artificial insemination, estrous expression was categorized as intense, moderate, weak, or negative. Pregnancies were confirmed between 40 to 70 days after artificial insemination using either pregnancy-related glycoprotein or ultrasonography examinations.Intense, moderate, weak, and negative estrus intensities were observed at rates of 20%, 20%, 26.7%, and 33.3%, respectively, in the Ovsynch group and 41.7%, 58.3%, 0%, and 0%, respectively, in the Co-synch group (P

Burden of cancers in six female organs in China and worldwide.

Cancers in female organs remain a substantial burden in China and worldwide. GLOBOCAN 2022has recently updated the estimates of cancer burden. This study aims to depict the profiles of disease burden and to compare the age-specific rates of cancers in female organs in China with those in other countries. The latest estimates of incidence and mortality of cancers in female organs from various regions and countries were extracted from the GLOBOCAN 2022database. We compared the proportion of total cases or deaths for cancers affecting six female organs and other tumor types in China and globally. Correlation analysis was conducted to evaluate the relationship between age-standardized incidence rate (ASIR) or age-standardized mortality rate (ASMR) and the Human Development Index (HDI). Additionally, age-specific rate curves were plotted for ten exemplary countries with different income levels. Globally, there are varying burdens of female organ cancers, with higher incidence rates in Northern America and elevated rates of cervical cancer in Africa. Female organ cancers in China remain a significant burden due to their large proportion of the six tumors. A positive correlation between socioeconomic development and the incidence of breast, uterine corpus, ovarian, and vulvar cancers was noted, whereas a negative association between the HDI tiers and mortality rates was found for cervical and vaginal cancers. In 2022, Chinese women aged 50-54years are experiencing high incidence rates of breast, cervix uteri, corpus uteri, and ovarian cancers. Cancers in female organs continue to be a significant health concern for women in China and worldwide. It is crucial to implement comprehensive prevention strategies tailored to address the increasing trend among younger individuals and reduce regional disparities.